Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 601 | NM |
N | 207ND0101X | MOHS-Micrographic Surgeon | 601 | NM |
N | 207NS0135X | Procedural Dermatology | 601 | NM |
NPI | 1245225515 |
---|---|
Provider Name | Dr. Joel R Barkoff |
First Address | Albuquerque, NM 87109-2117 |
Second Address | Albuquerque, NM 87109-2117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02121 | (05) | NM |
C97149 | (02) | |
NM000212 | BCBS (01) | NM |